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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6708
Experience:  14 years as clinician in the field of Family Practice
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I have been having chest tightness and shortness of breathe.

Resolved Question:

I have been having chest tightness and shortness of breathe. I have recently had a ECG which has come back normal. My Peak Flow Meter reading is between 220 - 350. what could be causing the breathlessness?
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD :

Hello!

Anthony Bray MD :

Your peak flow reading is rahter low there actually....

Anthony Bray MD :

Do you have any history of respiratory allergies? Any cough or wheezing noted?

Anthony Bray MD :

Do you smoke?

Anthony Bray MD :

What is your height , weight and gender please >> these factors would impact your peak flow....

Anthony Bray MD :

From your history so far it seems likley that your heart function is more likley normal and that you may have some bronchospasm as a possible cause of tightness in the chest and shortness of breath.. I would advise you that this is for information purpioses to benefit you and is NOT a DIAGNOSIS..( As I can't examine you in person , I can't really truly diagnose your condition... )

Anthony Bray MD :

I hope this is of help to you...Let me know if you can provide further details and also if you have further questions>>>

Anthony Bray MD :

I will be happy to get back with you!

Anthony Bray MD :

If my answers are helpful and to your satisfaction by the conclusion of our interaction then please remember to leave positive feedback. That would be very much appreciated!

Anthony Bray MD :

Thank you and Best Regards,

Anthony Bray MD :

Anthony Bray MD

Customer:

My Mum has asthma but my doctor seems to think that it is not related to that

Customer:

I am breathlessness and can last from 5 - 20 mins

Customer:

i dont smoke

Anthony Bray MD :

I see... well as I said your peak flow appears to be abnormally low... it may be that you MIGHT have benefit to have a trial of an inhaled broncholdilater...

Customer:

I am 5ft 5 10st 11 and i am female

Anthony Bray MD :

On the other hand the short dyuration of your symptoms makes me wonder of the possibility of panic attacks as a possible cause... panic attacks usually last less than 30 minutes and may make you feel short of breath and tight in the chest...

Anthony Bray MD :

Do you think that this latter is possible?? Do you have much anxiety with this??

Customer:

the doctor said on my first visit that oxygen levels on the finger pulse oximeter was low but much better on the second visit

Anthony Bray MD :

Do you recall what your readings were exactly or only the 1st low and 2nd was normal??

Customer:

doctor didnt say just that 1st low and 2nd was much better

Anthony Bray MD :

A low pulse ox reading would seem to be more consistent with a pulmonary cause of your symptoms. It would NOT be low due to a panic attack for example....

Anthony Bray MD :

This makes me think that asthma like your mother seems to be more likely a possible cause....

Customer:

is there a chance that the doctor could over look asthma if i was not there when breathless?

Anthony Bray MD :

Do you have any coughing , sneezing, wheezing too or simply the tight feeling and feeling short of breath??

Anthony Bray MD :

Bronchospasm of mid size to larger airways may cause a sense of tightness..

Customer:

coughing breathlessness (breathing deeply trying to catch breath) and chest feels tight

Anthony Bray MD :

Yes it is very possible because asthma may come and go with regard to its nature...

Customer:

would this show up on chest xray

Customer:

as the doctor has ordered BNP blood test and fasting blood test - what would these tests be for?

Anthony Bray MD :

No your chest xray may appear perfectly normal.... it may at times show a finding we refer to as hyperventilation... too clear sue to air trapping....

Anthony Bray MD :

BNP would be to screeen for congestive heart failure...

Anthony Bray MD :

What is your age??

Anthony Bray MD :

Bronchospasm of the small airways would be the type that causes the noticeable wheezing...

Customer:

23

Customer:

ok - also when the doctor listened first time to by chest he said it sounds a bit tacycardic - then second time said its sounds fine - would that be normal for asthma if was feeling ok at the time

Anthony Bray MD :

OK then at age 23 the possibility of congestive hearty failure of any type would be very LOW indeed!!!

Anthony Bray MD :

I would advsie that you consider seeing a pulmonary specialist... this may be a good option for you... I think that a trial of a broncholdilator whae you are symptomatic may be aq reasonable approach for you...

Anthony Bray MD :

Asthma would more fit as a presentation that would be more likely to fit with your age as well....

Anthony Bray MD :

I would advsie that you consider seeing a pulmonary specialist... this may be a good option for you... I think that a trial of a broncholdilator whae you are symptomatic may be aq reasonable approach for you...

Anthony Bray MD :

Tachycardic would only mean that your heart rate was high... this could be a response to your distress... the rate if you knew that would be helpful...

Customer:

how would i go about doing that

Anthony Bray MD :

This will vary at different times....

Anthony Bray MD :

Oh just check your pulse rate... count beats for 15 seconds and multiply that by four....

Customer:

its around 77 beats per minute

Customer:

is that the Blood pressure

Anthony Bray MD :

Normal RESTING heart rate is 60 to 100...

Customer:

that was 141 or 144 over 87

Anthony Bray MD :

77 rate is within the normal range....

Anthony Bray MD :

Normal BP is usually between 110 to 135 / 60 to 85....

Anthony Bray MD :

Do you have episodes of it racing out of the normal range??

Anthony Bray MD :

A rhythm disturbance of the heart would be yet another possible cause of your symptoms...

Anthony Bray MD :

occasional highs due to stress would not be that unusual.. it is the average that counts more with regard to your BP...

Anthony Bray MD :

BP should be checked in sitting position after 10 minutes rest....

Customer:

ok normally it is normal - that was at the doctors

Customer:

*usually it is normal

Anthony Bray MD :

Yes I thought that that might well be the case.

Anthony Bray MD :

So I don't think that your symptoms would be due to your blood pressure then....

Customer:

ok

Anthony Bray MD :

It seems that bronchospasm still rises to the top of the list of possible cause for you....

Customer:

would that occur during exercise aswell

Customer:

even light such as dealing with the animals/ cleaning

Anthony Bray MD :

I think that further discussion of your symptoms and exam by a pulmonary specialist would likley benefit you.... I think that you may very well benefit from trying a bronchodilator such as Albuterol or Xopenex when you feel short of breath or tight in the chest....

Anthony Bray MD :

Yes >> exercise induced asthma is common presentation....

Customer:

that will have to come through prescription wont it?

Anthony Bray MD :

Yes you would need a prescription....

Customer:

would that be a referal from the doctor

Customer:

to that pulmonary specialist

Anthony Bray MD :

You could print out our discussion adn share this with your doctor or pulmonary specialist... that may be helpful for you....

Customer:

?

Customer:

ok thankyou

Anthony Bray MD :

Either your general doctor OR a pulmonolgist >> either could prescribe an inhaler if their thinking happened to be in agreement with mine on this issue....

Anthony Bray MD :

You are very welcome! I do hope that this is helpful for you!

Anthony Bray MD :

I hope that you get to feeling 100% on this again... Good luck to you!!

Anthony Bray MD :

I will switch this to Q and A format >> if you wish to print this out then this format would probably be better... you may continue to ask questions on this format.. the back and forth is a bit slower..

Customer:

thankyou - just last one question would it be helpful for the doctor if i recorded the peak flow meter results so that he can see it over a period of time

Anthony Bray MD :

Yes that would be helpful as well!!

Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6708
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 4 other Health Specialists are ready to help you
Expert:  Anthony Bray, MD replied 1 year ago.
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Customer: replied 1 year ago.

Thankyou for your help been very useful

Expert:  Anthony Bray, MD replied 1 year ago.

Hello again!

 

Yes >> if you measured peak flows over time and recorded these then that would be very helpful to your doctor for interpretation....

 

Let me know if you have further questions and I will be happy to get back wtih you!!

 

Take care,

 

Anthony Bray MD

Customer: replied 1 year ago.

I have been monitor ing my peak flowbreadings for 7 days


1. Morning 230 then 250


2. Morning 370 then 270 at night


3. Morning 320 1.20 wih symptoms 200 then 330 at night


4. 270 then 290


5. 390 then 340


6. 330 then 5.30 symptoms was 250 then 350 night


7. 310 then 250 with symptoms after whole day with walking around and goimg up and down stairs


 


Would these readings fit in with what you thouught it was the other day with breathless and tight chest

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Yes I think that your peak flow readings and variations are consistent with airway obstruction (asthma in other words) your peak flow should probably be at least in 400-500 range. ( mine is > 900 but as a male and at 6'0 mine would be expected to be greater due to lung size difference--- still mine should NOT be more than twice yours!!)

Your history and peak flow readings would seem consistent with you probably having some degree of asthma. If this would only caused by exertion then you could have exercise induced asthma.asthma more typically is related to airway inflammation and/or hyper-reactivity.

I think that you would likely benefit to try a bronchodilator in response to symptoms. You may well benefit from other treatments as well such as treatment to reduce airway inflammation.

I would recommend full pulmonary function testing which provides more complete information than the peak flow alone. ( peak flow is great in that it is cheap, easy, available and useful though)

I hope this helps! Let me know if I may be if further help to you!! Positive feedback on my responses to you would be very much appreciated! Thank you and best regards!!

Anthony Bray MD
Customer: replied 1 year ago.


Ok thankyou, it is not always by excercise but was made worse today by exercise and has other times but can be when just on the computer as i have been back for a good 5 hours after walking around all day on a trip


 

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I would suspect that you may have allergy component to trigger the asthma. This time of year pollen outside is a common culprit. This could fit with your history of gradual symptoms following a walk. Exercise plus allergies as triggers would be common scenario.... Having symptoms more during certain seasons is common ( spring most frequently is worse with the high pollen counts)

Your response to trial of therapy such as a bronchodilator would be helpful in establishing the diagnosis as well.

I hope this is helpful for you! Let me know if I may be if further assistance to you! Take care,

Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6708
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 4 other Health Specialists are ready to help you

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